Agreement and Associations between Countermovement Jump, 5-Time Sit-To-Stand, Lower-Limb Muscle Power Equations, and Physical Performance Tests in Community-Dwelling Older Adults

Objectives: The present study examined the agreement and associations of the 5-time sit-to-stand (5STS) test, the countermovement jump test, and lower-limb muscle power equations with a set of physical performance tests in older adults. Methods: Five hundred and thirty-four community-dwelling older adults were recruited for the study. Lower-limb muscle power measures included 5STS, the countermovement jump test, and muscle power equations. Isometric handgrip strength, timed "up-and-go!", the 6 min walking test, one-leg stand, and walking speed at usual and fast paces were used to assess physical performance. Pearson's correlations and Bland-Altman analyses were conducted to examine associations among muscle power measures. Linear and multiple regressions were run to explore associations of 5STS, the countermovement jump test, and muscle power equations with physical performance tests. Results: Weak correlations were observed among lower-limb muscle power measures. Bland-Altman results indicated important differences among the countermovement jump test, 5STS, and muscle power equations. Results of multiple linear regressions indicated that 5STS, the countermovement jump test, and muscle power equations were significantly associated with measures of muscle strength and mobility. However, only 5STS was significantly associated with balance. Conclusions: Our results indicate that the performance on the countermovement jump test and 5STS is weakly correlated with lower-limb muscle power equations. The only exception was the correlation found between the countermovement jump test and relative muscle power, highlighting the importance of accounting for body mass in muscle power evaluations. Muscle power measures were similarly associated with performance on handgrip strength, timed "up-and-go!", and the 6 min walking test. The exclusive association of 5STS with balance suggests that a reassessment of 5STS muscle power equations may be warranted.

Magnitude of vertical ground reaction force during water-based exercises in women with obesity

Individuals with obesity are recommended to practice physical activity with reduced weight bearing, such as water-based exercises. However, the magnitude of the vertical ground reaction force (Fz) during these exercises is unknown in this population. This study aimed to verify the magnitude of peak Fz (Fzpeak) in women with obesity during different exercises performed in water and on land and at different intensities. Ten adult women with obesity class 1 (body mass index: 31.6 ± 0.57 kg·m-2) completed two randomised sessions, one performed on land and other in water, composed by three exercises (stationary running, frontal kick, butt kick) performed at cadences of 80 b·min-1, 100 b·min-1 and maximal. Fzpeak value was determined in each situation. Data were analysed using repeated-measures three-way ANOVA (α = 0.05). Significant lower Fzpeak values were observed in water (p < 0.001), with no significant differences between the exercises. A significant difference in the Fzpeak was verified between maximal cadence and 80 b·min-1 (p = 0.01). Water-based exercises performed by women with obesity revealed a Fzpeak reduction from land to water corresponding to 41-67%. Also, the three water-based exercises resulted in similar Fzpeak values, while an increase was observed 80 b·min-1 to the maximal cadence.

Differences in kinetic characteristics during countermovement jump of football players with cerebral palsy according to impairment profiles

Objectives: The purpose of this study was 1) to determine and compare kinetic parameters during the realization of a countermovement jump (CMJ) between footballers with cerebral palsy (CP) and non-impaired footballers, and 2) to analyze the differences in this action between different players' impairment profiles and a group of non-impaired footballers. Methods: This study involved 154 participants comprising 121 male footballers with CP from 11 national teams and 33 male non-impaired football players recruited as the control group (CG). The footballers with CP were described according to the different impairment profiles (bilateral spasticity = 10; athetosis or ataxia = 16; unilateral spasticity = 77; minimum impairment = 18). All participants performed three CMJs on a force platform to record kinetic parameters during the test. Results: The group of para-footballers presented significantly lower values than the CG in the jump height (p < 0.01, d = -1.28), peak power (p < 0.01, d = -0.84), and the net concentric impulse (p < 0.01, d = -0.86). Concerning the pairwise comparisons between CP profiles and the CG, significant differences were found for the bilateral spasticity, athetosis or ataxia, and unilateral spasticity subgroups compared to the non-impaired players for jump height (p < 0.01; d = -1.31 to -2.61), power output (p < 0.05; d = -0.77 to -1.66), and concentric impulse of the CMJ (p < 0.01; d = -0.86 to -1.97). When comparing the minimum impairment subgroup with the CG, only significant differences were found for jump height (p = 0.036; d = -0.82). Footballers with minimum impairment presented higher jumping height (p = 0.002; d = -1.32) and concentric impulse (p = 0.029; d = -1.08) compared to those with bilateral spasticity. Also, the unilateral spasticity subgroup reports a higher jump height performance than the bilateral group (p = 0.012; d = -1.12). Conclusion: These results suggest that the variables related to power production during the concentric phase of the jump are crucial for the performance differences between groups with and without impairment. This study provides a more comprehensive understanding of kinetic variables that would differentiate CP and non-impaired footballers. However, more studies are necessary to clarify which parameters better differentiate among different profiles of CP. The findings could help to prescribe effective physical training programs and support the classifier's decision-making for class allocation in this para-sport.

Effects of Plyometric Jump Training on Measures of Physical Fitness and Sport-Specific Performance of Water Sports Athletes: A Systematic Review with Meta-analysis

BACKGROUND

A growing body of literature is available regarding the effects of plyometric jump training (PJT) on measures of physical fitness (PF) and sport-specific performance (SSP) in-water sports athletes (WSA, i.e. those competing in sports that are practiced on [e.g. rowing] or in [e.g. swimming; water polo] water). Indeed, incoherent findings have been observed across individual studies making it difficult to provide the scientific community and coaches with consistent evidence. As such, a comprehensive systematic literature search should be conducted to clarify the existent evidence, identify the major gaps in the literature, and offer recommendations for future studies.

AIM

To examine the effects of PJT compared with active/specific-active controls on the PF (one-repetition maximum back squat strength, squat jump height, countermovement jump height, horizontal jump distance, body mass, fat mass, thigh girth) and SSP (in-water vertical jump, in-water agility, time trial) outcomes in WSA, through a systematic review with meta-analysis of randomized and non-randomized controlled studies.

METHODS

The electronic databases PubMed, Scopus, and Web of Science were searched up to January 2022. According to the PICOS approach, the eligibility criteria were: (population) healthy WSA; (intervention) PJT interventions involving unilateral and/or bilateral jumps, and a minimal duration of ≥ 3 weeks; (comparator) active (i.e. standard sports training) or specific-active (i.e. alternative training intervention) control group(s); (outcome) at least one measure of PF (e.g. jump height) and/or SSP (e.g. time trial) before and after training; and (study design) multi-groups randomized and non-randomized controlled trials. The Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the included studies. The DerSimonian and Laird random-effects model was used to compute the meta-analyses, reporting effect sizes (ES, i.e. Hedges' g) with 95% confidence intervals (95% CIs). Statistical significance was set at p ≤ 0.05. Certainty or confidence in the body of evidence for each outcome was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE), considering its five dimensions: risk of bias in studies, indirectness, inconsistency, imprecision, and risk of publication bias.

RESULTS

A total of 11,028 studies were identified with 26 considered eligible for inclusion. The median PEDro score across the included studies was 5.5 (moderate-to-high methodological quality). The included studies involved a total of 618 WSA of both sexes (330 participants in the intervention groups [31 groups] and 288 participants in the control groups [26 groups]), aged between 10 and 26 years, and from different sports disciplines such as swimming, triathlon, rowing, artistic swimming, and water polo. The duration of the training programmes in the intervention and control groups ranged from 4 to 36 weeks. The results of the meta-analysis indicated no effects of PJT compared to control conditions (including specific-active controls) for in-water vertical jump or agility (ES =  - 0.15 to 0.03; p = 0.477 to 0.899), or for body mass, fat mass, and thigh girth (ES = 0.06 to 0.15; p = 0.452 to 0.841). In terms of measures of PF, moderate-to-large effects were noted in favour of the PJT groups compared to the control groups (including specific-active control groups) for one-repetition maximum back squat strength, horizontal jump distance, squat jump height, and countermovement jump height (ES = 0.67 to 1.47; p = 0.041 to < 0.001), in addition to a small effect noted in favour of the PJT for SSP time-trial speed (ES = 0.42; p = 0.005). Certainty of evidence across the included studies varied from very low-to-moderate.

CONCLUSIONS

PJT is more effective to improve measures of PF and SSP in WSA compared to control conditions involving traditional sport-specific training as well as alternative training interventions (e.g. resistance training). It is worth noting that the present findings are derived from 26 studies of moderate-to-high methodological quality, low-to-moderate impact of heterogeneity, and very low-to-moderate certainty of evidence based on GRADE. Trial registration The protocol for this systematic review with meta-analysis was published in the Open Science platform (OSF) on January 23, 2022, under the registration doi https://doi.org/10.17605/OSF.IO/NWHS3 (internet archive link: https://archive.org/details/osf-registrations-nwhs3-v1 ).

The Effectiveness of Aquatic Plyometric Training in Improving Strength, Jumping, and Sprinting: A Systematic Review

CONTEXT

Aquatic plyometric training may provide benefits due to reduced joint loading compared with land plyometric training; however, the reduced loading may also limit performance gains.

OBJECTIVE

To systematically review the effect of aquatic plyometric training on strength, performance outcomes, soreness, and adverse events in healthy individuals.

EVIDENCE ACQUISITION

Five databases were searched from inception to June 2020. Quality assessment and data extraction were independently completed by 2 investigators. When similar outcome measures were used, standardized mean differences were calculated.

EVIDENCE SYNTHESIS

A total of 19 randomized controlled trials with 633 participants (mean age, range 14-30 y) were included. Aquatic plyometric training was most commonly performed in waist to chest deep water (12/19 studies), 2 to 3 times per week for 6 to 12 weeks (18/19 studies), with final program foot contacts ranging from 120 to 550. Meta-analyses were not completed due to the clinical and statistical heterogeneity between studies. Compared with land plyometric training, aquatic plyometric training exercises and dosage were replicated (15/16 studies) and showed typically similar performance gains (3/4 knee extensor strength measures, 2/4 leg extensor strength measures, 3/4 knee flexor strength measures, 7/10 vertical jump measures, 3/3 sprint measures). In total, 2 of 3 studies monitoring muscle soreness reported significantly less soreness following training in water compared with on land. Compared with no active training (no exercise control group or passive stretching), most effect sizes demonstrated a mean improvement favoring aquatic plyometric training (23/32 measures). However, these were not significant for the majority of studies measuring isokinetic knee strength, vertical jump, and sprinting. The effect sizes for both studies assessing leg press strength indicated that aquatic plyometric training is significantly more effective than no training.

CONCLUSION

Aquatic plyometric training appears similarly effective to land plyometric exercise for improving strength, jumping, and sprinting and may be indicated when joint impact loading needs to be minimized. However, the low quality of studies limits the strength of the conclusions.

A systematic review and meta-analysis comparing the effect of aquatic and land exercise on dynamic balance in older adults

BACKGROUND

Balance impairments are the leading causes of falls in older adults. Aquatic-based exercises have been broadly practiced as an alternative to land-based exercises; however, the effects on dynamic balance have not been comprehensively reviewed and compared to land exercises. Thus, the purpose of this systematic review and meta-analysis was to compare the effectiveness of aquatic exercises (AE) to land exercises (LE) on dynamic balance in older adults.

METHODS

Electronic databases (PubMed, MEDLINE, CINAHL, SPORTDiscus, psycINFO), from inception to November 2019, were searched. Studies met the following eligibility criteria: Randomized controlled trials, English language, older adults aged 65 years or older, a minimum of one AE and LE group, at least one assessment for dynamic balance. For the meta-analysis, the effect sizes of dynamic balance outcomes were calculated using a standardized mean difference (SMD) and a 95% confidence interval (CI).

RESULTS

A total of 11 trials met the inclusion criteria, and 10 studies were eligible for the meta-analysis. The meta-analysis presented that older adults in AE groups demonstrated comparable enhancements in dynamic steady-state balance (SMD = - 0.24; 95% CI, -.81 to .34), proactive balance (SMD = - 0.21; 95% CI, -.59 to .17), and balance test batteries (SMD = - 0.24; 95% CI, -.50 to .03) compared with those in LE groups.

CONCLUSIONS

AE and LE have comparable impacts on dynamic balance in older adults aged 65 years or older. Thus, this review provides evidence that AE can be utilized as a reasonable alternative to LE to improve dynamic balance and possibly reduce the risk of falls.

Identification of Tools for the Functional and Subjective Assessment of Patients in an Aquatic Environment: A Systematic Review

Aquatic therapy is one of the most common treatments for alleviating musculoskeletal pathologies. Its effectiveness has been evaluated with functional tests and questionnaires. Functional tests are used in aquatic therapy; however, in most cases, they are carried out in a non-aquatic environment and, as such, their results may differ from those of tests performed in an aquatic environment. A systematic review was performed to assess the accuracy of functional tests and patient-reported outcomes to assess aquatic therapy interventions. The authors conducted a literature search in July 2019. In total, 70,863 records were identified after duplicates removed. Of these, 14 records were included about functional tests assessment in aquatic environment and 725 records for questionnaires. The majority of the tests had also been assessed in a dry environment, allowing differences and similarities between the tests in the two environments to be observed. Different variables have been assessed in tests included in the present systematic review (cardiorespiratory, neuromuscular, kinematic, physiological, kinetic responses and rating of perceived exertion) which are included in the manuscript. Visual Analogue Scale, Western Ontario and McMaster Universities Osteoarthritis Index and the 12-item Short Form Health Survey were the assessments most commonly used by the different authors.

Vertical Ground Reaction Force During a Water-Based Exercise Performed by Elderly Women: Equipment Use Effects

Purpose: The present study aimed to compare the vertical ground reaction force responses during the performance of the stationary running water-based exercise with and without equipment at different cadences by elderly women. Method: Nineteen elderly women (age: 68.6 ± 5.0 years; body mass: 69.0 ± 9.5 kg; height: 154.9 ± 5.6 cm) completed one session consisting of the performance of the water-based stationary running with elbow flexion and extension immersed to the xiphoid process depth. The exercise was performed in three conditions, without equipment, with water-floating and with water-resistance equipment, at three cadences (80 b·min^-1, 100 b·min^-1 and maximal) in a randomized order. Peak and impulse of vertical ground reaction force were collected during the exercise using an underwater force plate. Repeated measures two-way ANOVA was used (α = 0.05). Results: Peak vertical ground reaction force (p < .001) and impulse (p ≤ 0.002) resulted in lower values for the water-floating use (0.42-0.48 BW and 0.07-0.13 N.s/BW) in comparison to the water-resistance equipment use (0.46-0.60 BW and 0.09-0.16 N.s/BW) and to the non-use of equipment (0.45-0.60 BW and 0.07-0.17 N.s/BW), except for the impulse at the maximal cadence. In addition, peak vertical ground reaction force at 80 b·min^-1 (p = .002) and impulse at the maximal cadence (p < .001) showed lower values compared to the other cadences. Conclusion: The use of water-floating equipment minimizes the vertical ground reaction force during the stationary running water-based exercise performed by elderly women regardless of the cadence.

Effects of land vs water jump exercise: Implications for exercise design targeting bone health

PURPOSE

To quantify ground reaction force (GRF), osteogenic index (OI), muscle activity, and blood lactate levels during continuous jumping performed in water and on land.

METHODS

Thirteen post-menopausal women (59.5 ± 6.8 years) performed two bouts of jumping, on land (LND) and in water at a depth of 1 m (WEX). Each 10-minute, 40-second bout consisted of 2 consecutive sets of squat, lunge, jumping jax, countermovement, and single legged jumps as intervals: 10 seconds maximal effort and 60 seconds recovery at 50% of heart rate reserve (HRR). Pre- and post-exercise lower extremity rate of perceived exertion (RPE) was recorded, and 10-µL earlobe blood samples were collected to assess lactate concentration. During exercise, data were collected for electromyography, GRF, and heart rate. Total GRF (TGRF) and total muscular activity (TMA) during each 10 seconds of jumping were measured. OI for one bout of continued jumps was determined by averaging GRF·ln (number of jumps + 1).

RESULTS

There were no differences between WEX and LND for percent HRR and RPE. TGRF, OI, TMA, and lactate concentration on LND jumps were significantly higher than WEX.

CONCLUSION

At similar cardiorespiratory and RPE levels, the lower impact loading of 10 minutes 40 seconds of interval continuous jumping exercise in 1-m depth was less osteogenic than on land. However, one daily bout of water jumping, 5 days per week resulted in a similar OI as 3 days of jumping on land. WEX might substitute or provide an adjunct to LND exercise to promote bone health.